Oral health in the United States has dramatically improved during the preceding decades, yet some groups, like African American adults, remain at risk of dental disease and are more likely to experience poor oral health. While this problem is generally acknowledged, it is presently under-studied. The goal of the proposed research is to understand Nu these adults are at greater risk to disease by gathering contemporary psychosocial and health data on a representative sample of African Americans. From the research, a model of health behavior and oral health will be developed that will be a useful tool for planning interventions for this high risk population. The specific aims of the project are to 1) identify demographic, enabling, cultural, and psychological factors that influence self-care and professional care among African Americans, 2) assess and contrast dental behaviors (self-care and utilization of professional care) between African Americans and white Americans and relate the behaviors to the demographic and psychosocial factors, 3) assess oral health outcomes (dental caries, periodontal status, tooth loss, tooth replacement) in the two groups and relate the outcomes to dental behaviors, 4) examine the relation of subjects' oral health status to dental provider factors such as dentist availability, acceptance of insurance, and racial bias and 5) develop a conceptual model of health behavior and oral health for African Americans. Subjects will be a disproportionate probability sample of 800 adults (400 African Americans, 400 whites) age 18-74 years residing in the Detroit tri-county area. Data will be collected by a) face-to-face interviews, b) dental examinations and observations of self-care behaviors, and c) a mailed survey of subjects' dentists. Qualitative pilot studies will be used to develop and refine measures for the face-to-face and dentist surveys. Multivariate data analyses will be used to determine the relation of the factors to self-care, utilization of professional care, and oral health status. The project will make a significant contribution by beginning development of a model of health behavior and oral health for adult African Americans. The model will be useful when planning interventions to increase self-care behaviors, encourage appropriate utilization of dental care, and enhance the oral health of individuals at greater risk of dental disease.